Total gastrectomy. A 15-year experience with particular reference to the patient over 70 years of age.

Between 1969 and 1984, a total of 186 patients underwent total gastrectomy. Seventy-four patients were more than 70 years of age. Surgical mortality was 13.4%, with only minor differences between those patients younger than 70 years and older patients--12.5% and 14.8%, respectively. Moreover, there was no major difference if surgery was curative or merely palliative. Of 27 patients with tumors at TNM stage IV, only one died. Of the 100 patients who were operated on during the five-year period between 1979 and 1984, only four died, for an operative mortality of 4%. These results suggest that this remarkable decline of mortality is due to a precise standardization of surgical technique and improvements in preoperative patient management and aftercare. The five-year survival was 15.9%; again, there was no major difference between the group of patients older than 70 years and those younger than 70 years (19.4% and 14.5%, respectively). The ten-year survival was 4.9%.